The first report on Devon health services since the county was put in special measures (re-branded as a “Success Regime” !) is published today and promises (threatens?) major changes, some of which “may” need public consultation at a later stage. Oh, and Owl likes the way the phrase “best performing” is used to mean “cheapest”!
The usual buzz words abound: transformation, best practice, latest thinking, latest technology …. One surprising finding is that community hospitals are under-used:
“Possible changes that could be considered to achieve the aims of the Success Regime programme range from looking at highly specialised services covering the whole of Devon and Cornwall, and possibly beyond; and further investigation into community hospital beds in Devon because the report says there is still a lot of space in community hospitals that is not being used.”
Is it that space is not being used or there are not enough members of staff available to use it? And which are the community hospitals that fall into this category?
What next? According to the (very long) press release:
“There have been 20 opportunities identified in the document. Out of those we will be looking at the options that might emerge, and how we engage with patients and the public.
“That will be by March or April, and those 20 opportunities will become four or five options to move into more diagnostic consultation.
“There will be some things we can just get on and do such as addressing agency staff as they are operational matters. Other options will require much more engagement and there will be some consultation with people in the summer months.”
In the meantime they have published some of their initial findings:
“The ‘Case for Change’ facts:
. Health and social care spending in Devon was £1.9bn in 2014/15.
. Local health and social care organisations are facing a financial shortfall in 2015/16 of £122m, rising to £442m in 2020/21 if nothing changes.
. People in Devon are living longer. More than one in five people are over the age of 65, rising to one in four by 2021.
In Devon, 3.1 per cent are over the age of 85, higher than the national English average of 2.3 per cent.
. Devon is generally affluent but there are health inequalities in deprived areas.
• There are 280,000 local people, including 13,000 children, living with one or more long-term condition such as asthma, cancer and mental illness.
. Around 150,000 people in Devon have a mental illness.
.There are 40,000 people with cancer.
• Around 95,000 people with a long-term condition also have a mental illness.
. Local health and social care services are likely to be £442m in debt by 2020/21 if nothing changes.
. There is predicted to be 37,000 more emergency admissions to local hospitals over the next five years, an increase of more than 30 per cent. Many of these admissions are preventable.
• An estimated £85m is being spent on areas where staff may be able to provide the same quality of service but more efficiently.
. Over £30mwas being spent on temporary staff in hospitals in 2014/15.
. Up to £25m could be saved on clinical supplies if hospitals work together to buy them.
. Up to £21m could be saved by matching spend on continuing care to best performing areas.
. A third of bed space in community hospitals is empty or under-used.
. Every day, more than 500 people are in local hospitals when they could be elsewhere. Most of them are old and many have dementia.
. Over half the people in Devon who are fit to leave the community hospital have been waiting to leave for at least four days. It costs £250 per day to care for someone in an acute hospital bed.
• There are difficulties recruiting and retaining staff at all levels. Almost a quarter of GPs in Devon intend to leave the NHS in the next five years.